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Hello again. As expected, more questions are coming up.



My mother established a trust with a local law firm years ago and I'm her trustee as well as her MDPOA. I spoke with the law firm and they have an elder care coordinator on staff. They work cooperatively to make sure their client gets proper care and everything is done legally.



Her fee is $5,000 for the first year and decreases with time as the care plan is established and implemented. She would ensure things like medicaid is applied for in a timely fashion, etc. Mom will not need medicaid for several years as she can afford private pay right now.



Anyone have experience hiring an elder care coordinator? Is it worth it? She would be local in CO while I live in WA.

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Will this person also coordinate with you when mom is taken to the ER or needs a specialist ollow-up appointment? Will she arrange transportation and an aide to accompany mom to doc appointments?

That's the service I would be looking for, generally done by a geriatric care manager.
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Scbluheron May 2023
Hi. Yes, those would be some of the services she'd assist with. She mentioned the term geriatric care manager and I think it may be interchangeable with elder care coordinator.

I'm just not sure if the fee is worth the possible services. It sounds like it might be but wanted to get opinions from individuals who may have used similar services.
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I haven't but have friends who are trying (desperately) to get their LO to agree, because they can't respond to her mant emergencies.
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I'd be careful with that. It sounds nice on paper. And she might say all the right things, to try to sell it to you. But when reality happens, she might not follow through and you'll be the one dealing with ER, transportation, aides not showing up...

(She'll follow through with getting the Medicaid application done. That's the easy part, compared to all the other things that can go wrong with health, daily; and someone needs to help solve those problems.)

The only way to really know, would be to speak to other clients of hers. How satisfied are they? But I doubt she'll let you ask, even if a client would be willing to talk.
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ventingisback May 2023
OP, the way I solved the problem, was instead of hiring a coordinator/manager (like you, I almost did too), I found (after searching a lot) a team of private caregivers (not an agency; I've had many bad experiences with incompetent, stealing, no-show agencies). I organized live-in private caregivers for my Mom. They take shifts, rotate during the week. So far they've been VERY reliable, and genuinely CARING. They take care of ALL the problems that arise during the day.

This has made life much easier for me. I was dealing with all that, before.

There are still problems I help out with, but things have improved for me. It was not easy to find good live-in caregivers. It took a long time to find them.
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Is mom in AL or home? It would be wise to arrange for the coordinator to meet with moms physician, or social worker from the facility. Do some online research. Maybe speak to the Dept of elder affairs to get some advice.
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Patathome01 May 2023
Her mom lives alone at home and should be in memory care.
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For what it's worth, I can share my experience. My brother has dementia that is worsening, is bedbound and lives in a RCFE in CA. I live in MA. He never married and has no kids so I am his closest relative and I have DPOA.
I asked this forum about what to do, managing his care long distance and was given a lead to a site re Geriatric Care Managers. I found one I liked who lives just minutes away from my brother. I interviewed her (I'll call her GC) and she gave me 2 references and I had long talks with both of them and was satisfied.
GC runs her own business as an elder care advocate and my brother is one of several clients she manages. She charges $145/hour and sends a detailed invoice once a month. She and I confer by phone and text and email; she is there with my brother in his room when he has doctor visits (either by phone or video or in person) to act as his advocate. He would not be able to manage phone or video appts without her help. She also provides the doctor(s) with information that my brother forgets or denies. If I am not able to attend via conference call she sends me a detailed report afterward with the facts but also her impressions.
GC is my eyes/ears and nose at my brother's facility. I have a pretty good relationship with the administrator there, who will text me or call me if there are any acute issues (such as when my brother fell out of bed), but nothing can replace being on-site. GC visits my brother once a week, chats with him and brings him snacks. She is not a nurse or aide, but a facilitator and truly an advocate for my brother.
Of course it's not ideal, nothing would be ideal for him except if I lived right there with him and had no life of my own. But it has been a good compromise and worth the expense, which has been between $2000-4000/month depending on how much I ask her to do.
You quoted $5000/year: sounds like a bargain, but also maybe reflects how limited her services may be.
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Not worth the money. I'm going to let you in on something and it comes from 25 years experience in mostly elder care, and in business as a homecare provider.

If your mother has to go into facility care at some point, wherever she goes will have social workers that will start the Medicaid application the second she comes in the door.

If you already have her medical and financial POA, you will be the one making the decisions on her care decisions and how the bills will get paid. You are the one who will be making sure your mother gets proper care. This is the whole point of having someone's medical/financial POA. It is so the one appointed to it will act in the best interests of the person they have it for and will administer their finances responsibly and appropriately.

You do know that as the POA you are entitled to get paid out of your mother's funds. You can charge the $5,000 then reduce the fee yearly.
That it your right as POA to be compensated. The made-up nonsense title of "care coordinator" at a law firm is just one more way to bring in a few more bucks into the practice.
I would not even consider paying this if I were you.
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ventingisback May 2023
I agree with all you say.

I just want to add a warning to OP:

POA document normally explicitly says you have - no - right to be compensated as POA. And if it doesn't say so explicitly, it's implicit.

In other words, the only way you can really be compensated is, if the POA document explicitly mentions compensation. And even that's a bit tricky, because one thing is to be (1) reimbursed for expenses, another thing is to truly be (2) compensated/paid for POA work...at a certain $ limit, (2) would need to be in a formal caregiver contract, declaring taxes...

This is also why being POA doesn't create any obligation to act. It's not a job. It's not an obligation. You can't be sued for not-having-acted. POA gives you the opportunity to make decisions, if you choose to, but it doesn't oblige you to do that.

Of course, under some circumstances, one can be sued for neglect, abandonment...but that has nothing to do with being POA. That's true for anyone.
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These consulting services are becoming more frequently offered as this fills a need during an overwhelming and vulnerable time.

If you aren’t too bogged down, consider interviewing others local to her who are not affiliated with the legal office.

I did not use this service, but have friends who have found this to be a lifesaver!
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May or may not be for you. I paid $6K to an Elder Law firm 5 yrs ago knowing that at sometime I would need to put my husband in Memory Care after 12 yrs. Everything was pretty much set up but when I started visiting facilities I did not realize how limited I would be to go the Medicaid route. We have the savings and I am pretty much going to use all of it for my husband's care. I have learned that not any facility provides real one on one care so I hired his caregiver to go everyday and make sure he eats. He would not be eating as the facility only spends about 15 minutes trying to get everyone to eat...most eat on their own in some form.
My husband now does not understand how to open his mouth. He had lost 40 lbs. If you have to go direct to using Medicaid then I do not believe an Elder Atty is of much help. Hope this helps.
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I’m not sure it would be worth it at this point. You have your mom in AL so the choosing and moving of that is all done. She already has her financial stuff taken care of with a trust and giving you all the authority you need as well as the law firm and frankly having been through the Medicaid process for my mom I don’t really see how paying someone to do that works. First your mom is already in a facility so if and when the time comes they will help with that and either way you will still have to provide the intermediary with the information so it’s really just an extra person doing the same thing. When I went through the process for my mom I did it from 4 hrs away and they simply sent me a copy of anything they sent Mom so I was able to keep up and take care of things from here, someone you pay to do this will probably do the same and then ask you for the info the state is looking for.

If this person were weeding out residential care options for you or setting up and coordinating care at home, being you for your mom I could see it being worth the money but it sounds like those things have been done.
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NO!!! I think that is outrageous!

It is so easy to set up the Medicaid yourself. I had to do it for my disabled daughter. There are people who will help you along the way.

Please plan in home care for your mother, rather than looking at nursing homes. There are good programs out there. We have one here called IRIS which allows family members to also be care givers. You and/or your mother can make the decisions on what care she would like. You have control, instead of giving it over to the state. Do not let them take away your mother's rights or your families. There have been many instances of abuse and neglect in those homes. Make your mom's latter years happy ones, not horrible.
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* You first need to find out what her / their services provide and what experience they have to qualify for this type of position.
* It sounds like this person is a combination of a paralegal with geriatric training of some kind.
* Find out what their credentials are.
* Get a description of their services (and fees) in writing.
* Is this a person on staff at the law firm or do they contract out to him/her?

There will be additional costs that this care manager may have full responsibility to decide without your approval / input. Are you okay with this?

You may be out of the loop to interview, etc. so clarify with the law firm how much communication / updating you will want - weekly? monthly? certainly if any health / medical changes.

Check into a licensed social worker. Many are skilled / educated in medical issues and called medical social workers.

Read this:
https://college.mayo.edu/academics/explore-health-care-careers/careers-a-z/medical-social-worker/

Decision depends on:

1) how much time you want to spend monitoring.
2) what legal areas / needs require more than what you can / want to do
3) Financial ability.

You may be paying for the legal aspect of her 'care' although I do not know what that would be ...

Does this person managing work with one caregiver agency? more / others / how many? (they will have a well oiled system in place - which may be fine. Just know what it is).

- How do they assess care needed?
- Are they monitoring finances/investments?
- Do they charge YOU more for calls / communications? Are you 'on the clock' with this care managing person? (If associated with a law firm, they may have provisions for add'l costs).

Perhaps you will want to try it out for a year and see how things go.
Get everything in writing.

Gena / Touch Matters
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Scbluheron: Please be careful with this plan.
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Thank you everyone. I will hold off on this idea. It seemed to me like I'd be paying someone to do things that I am able and willing to do myself. Your answers mostly confirmed that thinking for me.
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Llamalover47 May 2023
Scbluheron: Thank you for your update.
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